Region G Team Web Site

State: MO Type: Model Practice Year: 2009

The Region G Team Web Site addresses the issue of improving essential services and building capacity through enhanced communication and resource sharing. The nine LHDs have been exploring the opportunity to work together on achieving accreditation, improve the relevant health status indicators, provide sounding boards for emerging health issues, and provide a forum for regional public health agencies to identify and discuss common issues, needs, and challenges. The LHDs of Region G recognized years ago that funding for public health programs was decreasing. We also were aware of the increase in the contract deliverables and the need to build our agency capacity by uniting and sharing our resources. We realized our health departments had common ground but we had different leadership styles, programs/services, and community support systems. To achieve our goals, we needed to be willing to share at all levels and trust each other. This takes support from our board of trustees, our leadership, and our employees. Administrators of small local health departments, recognized as political subdivisions in Missouri, wear multiple hats: chief executive officer, chief financial officer, human resource manager, legal advisor, program manager, public relations officer, and nursing practice advisor. The administrator must have the capability of filling in at various positions throughout the agency as the need arises. A large part of our day is spent at our desk at our various roles. By having the capability to consult with each other on any topic via the intranet, we have eliminated unnecessary meetings; share documents to create reports; discuss problems; share policies, procedures, strategic plans, community health assessments; and maintain more effective business management and practices. The goal is to strengthen the Region G collaborative public health system. To carry out the core functions and essential services we must share information, resources, and knowledge. We plan to become regionalized by sharing policies and procedures, which in turn would simplify the sharing of employees in any type of an emergency. This in turn will maximize strengths and increase resources at all nine health departments. The short-term outcomes of our practice are as follows: Web site is up and running; all nine LHD administrators and designees are trained in accessing and posting to Web site; all nine LHDs post appropriate documents to team site. The long-term outcomes of our practice are as follows: continued collaboration with the Region G administrators; all nine LHDs achieve accreditation; resource sharing will increase capacity to provide services; effective collaborations means we view each other as partners willing to share risks, resources, responsibilities and rewards. The members of this collaboration have a history of working together to ensure the health and safety of their residents. As small rural and remote LHDs, we need our partners to survive this ever-changing complex health care environment. As we move toward the future, LHDs must become leaders and embrace change. Accreditation is much more than a standard of quality, it is the foundation of our LHD’s structure, the commonality that will unify all LHDs with a solid base. Through our work as a collaborative, our goal is to identify the gaps and work collaboratively toward correcting these gaps so we will all have the capacity to provide the essential public health services.
The Region G Team Web Site focuses on the issue of improving essential services and building capacity through enhanced communication and resource sharing. During meetings with our collaborative partners, it was learned that only two of the partners had intranets with the capability of sharing information, calendars, and documents within their own agency. It was determined at that time that it would be extremely beneficial if the regional health departments could have a system linking them together with the same capabilities. Through this process the infrastructure and capacity building for each agency would be improved, thereby improving essential services to the region at large. The Region G Team Web Site is an innovative and practical approach to building a sustainable infrastructure to support resource and information sharing among nine autonomous LHDs. Literature review and Internet database research was conducted for evidence of this practice in the field of public health. The only evidence found was among the private sector businesses or governmental agencies having this capacity within their own agency. There was evidence of membership organizations soliciting dues having some of this capability but no evidence was found of this approach between local autonomous health departments. This practice unites through a secure intranet nine LHDs allowing for improved communication and increased resources through sharing. The practice can standardize policies and procedures throughout an expanded geographical area. This practice differs from other approaches in the regionalization of efforts to improve essential services rather than approaching the issue individually. As far as we could determine, this practice is not normally done between autonomous LHDs. There are efforts to improve infrastructure and capacity by federal and state agency assistance to LHDs, but these are not consistent due to funding streams. We have learned valuable lessons from the natural disasters that occurred this year. We have learned through this experience that we can only depend on our local departments for immediate assistance. Our region needs to look into putting systems in place to ensure effective response and to assure the 10 essential public health services.
Agency Community RolesIn 2007, the Douglas County Health Department was asked to subcontract with Missouri Highlands Health Care Clinic, an FQHC located in Ellington Missouri, as a partner in their Delta Rural Health Outreach Program. When we were first contacted by them as to how we could work together to achieve the goals, it seemed quite a stretch because we are more than 130 miles from each other. Because of our history of partnering with our local FQHC on Delta projects, Missouri Highlands chose us to be a key consortium member. Our first thoughts were how we could put together strategies to include our Region G local health departments to work together on achieving accreditation, improve the relevant health status indicators, provide sounding boards for emerging health issues, and provide a forum for regional public health agencies to identify and discuss common issues, needs, and challenges. Our nine health departments have a history of working together. We wanted to use information technology to provide a sustainable system linking us together for limited access use within our health departments and for public use with a Region G Web Site. We realize that to accomplish our goals we must be willing to share, communicate, and cheer each other on. The Douglas County Health Department has initiated and hosted the team Web site and provided training to the other LHD designated staff in the region. We look at our nine LHD partners as being a unique community. We have built on a past history of working together to collaborate on putting in place systems to build our capacity and infrastructure. We have connected our collaboration via this intranet to provide a more coordinated response, collectively make better decisions, and share existing resources rather than continually search for new resources. We hope to expand this relationship to include regional public health accreditation. Costs and ExpendituresInformation is an essential tool for our nine LHDs to provide the 10 essential services. The Region G intranet site was funded by the Douglas County Health Department and the Delta States Rural Development Network Grant Program. The server, Internet access, and IT support were provided by the Douglas County Health Department in-kind. Research and consultation with the department’s IT provider was conducted to select user-friendly, flexible, and cost-effective software. By purchasing the software we avoided ongoing fees and ensured sustainability. Grant funds were used to purchase the Sharepoint Server 2007 and end-user licenses at a cost of $1,454. The Missouri Department of Health and Senior Services provides DSL Internet connection to all local health departments. Each health department provided their own computer equipment and staff time. Mileage and meals for two trainings were funded by the Delta Grant Program. Technical consultation was provided by phone and email by the Douglas County Health Department. The project was designed to allow for growth, changes in technology, and easy maintenance. ImplementationSteps taken to achieve our goal of strengthening our public health system by implementing a Regional intranet are as follows: partners met and provided input on content of our intranet in November 15, 2007; Douglas County Health Department contracted with IT provider to design and implement a Web site that would provide limited access by each health department to the intranet; partners met to train on use of Web site; partners began posting and viewing information on Web site; one-on-one training continued with partners who had less experience in dealing with technology; partners became more proficient and were able to post documents to be used by the collaborative to complete the NACCHO final report by November 30, 2008. The goal is to strengthen the Region G collaborative public health system through a regional intranet. The objectives established to reach this goal are as follows: By May 1, establish a sustainable Internet system with limited access use for all nine autonomous health departments; intranet up and running March 3. By April 30, provide training for nine health department administrators and their staff designees in the use of team site; provided training at Region G administrators meetings on March 10 and April 7; also conducted one-on-one instruction via the phone and email. By June 30, exchange information by setting up discussion site, health department schedules, and surveys; postings started March 10 and can be tracked per participant on a monthly basis. By October 31, post policy manuals, procedure manuals, strategic plan, community health assessments, ordinances, documents, calendars, etc.; Douglas County posted Georgia State University power point—Your Role in Health and Economic Development; Wright County posted their statistics, resource guide, and community health action plan on April 8; Douglas County posted their community health assessment, letterhead and financial audit RFP on April 8; Shannon County posted their community health assessment on May 21; Douglas County posted their strategic plan on July 16; Wright County posted their policy manuals, ordinances, fee-for-service documents, employee documents, and billing documents on September 16; Douglas County posted their resource directory on September 18; Texas County posted their lab policy manual on September 30. By November 30, reduce in-person meeting time and travel, and expedite successfully meeting our NACCHO deliverables by posting documents to be used by the collaborative; Douglas County posted Region G charter and strategic plan on September 30; Douglas County posted model practice application on October 31; Douglas County posted NACCHO final report template and consultant’s final report on November 6; Douglas County posted cover page to include map for NACCHO final report on and Region G collaborative agreement on November 11; Carter, Douglas, Howell, Oregon, Ozark, Reynolds, Oregon, and Ozark Counties all posted the NACCHO final report by November 26; Texas County had connectivity issues over Thanksgiving holiday and posted NACCHO final report on December 5.
Not every health department had technology or Internet knowledge level to participate.
Nine LHDs have formalized their collaboration by charter agreement and strategic planning. Partner commitment is very strong. One hundred percent of the partners are represented at every meeting. The intranet system will allow for faster and more comprehensive communication to share resources and expand IT capabilities. Support is ensured by the system being in place, functioning, and in use by all nine LHDs. The Douglas County Health Department hosts the site and sees no barriers to maintenance and expansion.